Emergency medicine Australasia : EMA
-
Emerg Med Australas · Dec 2011
Case ReportsSevere hypothermia in myxoedema coma: a rewarming by extracorporeal circulation.
Myxoedema coma is the most lethal manifestation of hypothyroidism. It represents a true medical emergency, especially in the case of cardiovascular instability. ⋯ We report the case of an 84-year-old woman who presented to the ED with accidental hypothermia associated with myxoedema that was successfully managed by veno-arterial extracorporeal blood rewarming. This case suggests that veno-arterial extracorporeal rewarming appears to achieve a rapid and consistent rewarming rate and is less invasive and more readily available than cardiopulmonary bypass.
-
Emerg Med Australas · Dec 2011
Optimal management of mental health patients in Australian emergency departments: barriers and solutions.
The study aimed to describe: (i) the perceived barriers faced by emergency clinicians in the assessment and management of patients presenting with a mental health complaint to Australian hospital EDs; and (ii) perceived strategies to optimize care of the mentally unwell in the ED. ⋯ Although the provision of timely and quality care is expected for all patients attending EDs, there exist multiple barriers to provision of adequate care for ED patients presenting with mental illness. Many of these are systems-based and thus require systems-based solutions. ED clinician's perceive that improved educational opportunities in mental health, however, might alleviate some barriers they face. Consideration should be given to a comprehensive, quantitative mental health-related learning needs analysis of ED clinicians.
-
Emerg Med Australas · Dec 2011
Randomized Controlled TrialNitrous oxide/oxygen compared with fentanyl in reducing pain among adults with isolated extremity trauma: a randomized trial.
To compare the effectiveness of nitrous oxide/oxygen (N(2)O/O(2)) and fentanyl in relieving pain among patients with an isolated long bone fracture or main joint dislocation of the limbs. ⋯ Neither nitrous oxide/oxygen or fentanyl appeared to be superior to the other in relieving moderate to severe pain among emergency patients presenting with isolated limb fracture or dislocation. In an ED, increased use of nitrous oxide might reduce the overall need for opiate analgesia, and in our setting, the need for constant monitoring.